Surgeon and Breast Unit Volume-Outcome Relationships in Breast Cancer Surgery and Treatment

• DOI: 10.1097/sla.0b013e3182a66eb0
• Publication Date: 2013-08-29T13:13:46Z
• Authors: Ailbhe M. McDermott; Deirdre M. Wall; Peadar S. Waters; Shan Cheung; Mark Sibbering; Kieran Horgan; Olive Kearins; Gill Lawrence; Julietta Patnick; Michael J. Kerin
• Keywords: Sentinel Lymph Node Biopsy; Breast Neoplasms; Workload; Middle Aged; United Kingdom; 3. Good health; 03 medical and health sciences; Treatment Outcome; 0302 clinical medicine; Chemotherapy, Adjuvant; Humans; Female; Radiotherapy, Adjuvant; Practice Patterns, Physicians'; Mastectomy

To determine whether surgeon case volume and Unit affected specific recognized key performance indicators (KPIs) of breast cancer surgical management.An increasing body evidence suggests that a higher standard care, demonstrated by improved outcomes, is provided in high-volume units or surgeons. The volume-outcome relationship pertaining to screen-detected cancers has yet be thoroughly established remains pertinent issue view the debate surrounding screening.The study population comprised all women with new screen diagnosed between 2004-2005 2009-2010. Surgeons' mean annual patient volumes were calculated grouped as very low (<5), (5-15), medium (16-49), high (>50). effect screening unit was also evaluated. Statistical analyses performed using Minitab V16.0 software (State College, PA) R V2.13.0.There 81,416 patients aged 61 (±6.8) years treated 682 surgeons across 82 units. There 209 low-, 126 295 medium-, 51 proportion managed 1.2%, 6.9%, 65.5%, 25.7%, respectively. Patients more likely have breast-conserving surgery (BCS) than those low-volume (P < 0.001). sentinel lymph node biopsies (SLNB) invasive = 0.005). High-volume BCS SLNB 0.001 P 0.001, respectively).Even setting quality control measures potent influences on initial management treatment.